It actually happened: off statins!

[tendency]

Really hard to know without age, but if he has test results from 25 years ago then likely to be at least 45, which is old enough for risks to start being a real issue rather than some far away concern. And coronary calcium score is the ideal test to use if uncertain about starting statins or not , it classifies long term risk more accurately than standard risk factors in that situation.

Most people do not get any side effects from statins. Apart from rare muscle damage issues which are not hard to diagnose, the most common complaint by far is vague muscle soreness, but in large studies the odds of it on statins are more or less the same as for placebo.

No, results are current. I've had similar lipid panel numbers for the past 25 years. LDL number ranges between 170-225.

Interestingly, I had a Carotid Intima-Media Thickness (CIMT) Test done and very little arterial plaque build up was detected.

 

[tendency]

If your doctor wants you on a statin , it is most likely there is a reason. Family history is only one of many risk factors, the largest one by far is age, but also blood pressure, blood glucose, lipids , smoking , obesity. It is not hard to make an estimate of absolute cardiovascular risk from that information, and if high then statins and or other lipid lowering drugs are useful and reduce risk. No idea of the other risks but if you are taking reta then presumably weight is an issue, and the ldl numbers are pretty high. If lipids have been like that for 25 years then there has been lots of time to grow atherosclerotic lesions where you really do not want them to be, in coronary and cerebral arteries.

I essentially have no other risk factors that I'm aware of. Actually was taking reta for my lipid panel and glucose/A1c. Don't have a weight issue. No family history of CVD. Fasting glucose is 73, A1c is perfect, no smoking, BP is 118/72 etc.

 

[lessthanhalf]

Assuming you are not 70 yo then you probably do not have high absolute risk despite the ldl numbers, and absolute risk determines if statins are worth the effort. I am impressed that I guessed wrong about the reason for being on reta, I would have thought being overweight was a pretty safe bet. Atherosclerosis tends to be everywhere so not having much in your carotids is fairly good evidence , but not proof, there is not much elsewhere.

 

[tubby]

I essentially have no other risk factors that I'm aware of. Actually was taking reta for my lipid panel and glucose/A1c. Don't have a weight issue. No family history of CVD. Fasting glucose is 73, A1c is perfect, no smoking, BP is 118/72 etc.

Sounds like overall you're doing well with most of the more significant cardiovascular risk factors. High LDL is independently associated with cardiovascular risk, but it's a fairly weak association (as Calm pointed out, TG/HDL is a much tighter correlation).

I think where people get themselves into trouble is since doctors tend to fetishize LDL the patient starts following standard "LDL lowering" advice and in the course of doing so tank their HDL and boost their TG.

I maintain my belief that the primary reason LDL gets so much focus is simply because for many years it was the only things doctors could give you pills for that would change the number. If they saw that your HDL was too low, they didn't really have a pill to give you so didn't put much weight in tracking that. Same with triglycerides. But as soon as they got their magic LDL pills, boy were they suddenly tracking that one like a hawk!

 

[tendency]

Thanks for the feedback all, good stuff. I'll have some additional conversations with my doctor.

There is a cardiologist I follow online who did a good job summarizing the latest meta data studies on cholesterol and his take away was yes, if you have a family history of CVD you should be paying attention to the LDL number. If not, you're probably ok not treating it.

 

[ltjltj]

I'm nowhere near these elevated numbers and I'd still rather be on a low dose stating to get my LDL lower if given the option.